798-P: A Real-Life Experience with Hybrid Closed-Loop Insulin Delivery Systems in People with Type 1 Diabetes: One Year After

Objective: evaluate the metabolic impact and metrics of the new hybrid closed loop insulin delivery system on the quality of life in patients with type 1 diabetes.

Methods: Metrics obtained with CGM with >80% of CGM readings over a 4-week period in real life: Time in Range (TIR%) [target 70-180 mg/Dl (3.9-10mmol/L) ], Time Above Range (TAR%) [ (>180mg/dl (>10mmol/L) ], Time Below Range (TBR%) [<70mg/dl (3.9mmol/L) ], CV (<36%) referred to 30 consecutive days. Statistics ANOVA post-hoc Bonferroni/Tukey tests were used as appropriate.

Results: Fifty-two type 1 diabetic patients (38F; 14M) on SAP therapy aged 45.5±12.0 yrs, BMI 27.7±15.5 kg/m², duration of diabetes 24.6±13.4 yrs, were studied. In these patients, who were treated with total daily insulin (TDI) 0.55±0.16 UI/kg/day, basal 0.27±0.UI/kg/day, bolus 0.28±0.UI/kg/day, mean glucose was 158.6 mg/dl (8.8 mmol/L) (121-250) , TIR% 62.4±13.5%, TBR% 4.6±4.5%, TAR% 33.0±15.1%, CV% 36.1±5.2%. Only 19 of 52 patients reached TIR≥70%. A subgroup of 30 patients (21F; 9M) , mean age 44.2±12.2 yrs, BMI 29.2±19.7 kg/m², duration of diabetes 24.2±13.6 yrs, HbA1c 7.7±1.4%, TDI 0.59±0.14 UI/kg/day, basal 0.30 UI/kg/day, bolus 0.29 UI/kg/die, shifted from SAP to HCL. CGM Metrics regarding our patient's glucose status at baseline and 1, 2, 3, 6 and 12 months after, showed that: mean sensor BG decreased from 158.6 mg/dl (8.8 mmol/L) at baseline to 144.3 mg/dl (8.2mmol/L, p<0.05) at the 2^nd month, p<0.05. TIR% significantly increased from 62.4% (TBR 4.6%, TAR 33.0%, CV 36.1%) to 76% at the first month, to 76.5% (TBR 2.6%, TAR 20.9%, CV 33%) at the 3^rd month, p<0.05. After 12 months (n=10) TIR% was 73.4±8.8%, TBR% 2.7±3.1%, TAR% 23.9±7.2%, CV% 35.5±5.2%, p<0.05.

Conclusions: HCL improves glucose status increasing TIR% and reducing TAR%, TBR% and glycemic variability, improving the quality of life.